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Online Forms

Southern Pines Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, straight from our website and will have them ready for your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Returning Patients - Update Form

If you are a past patient or have a new acute issue we need to update your information!

Extremity Form

If you are having issues with something besides your back or neck, i.e. foot, shoulder, knee, etc. please fill out this form as well as the New Patient Health History or Returning Patient form.

Headache Form

If you are seeing us and are experiencing headaches, please fill out this form as well as the New Patient Health History or Returning Patient Form.

Accident Form

If you are coming to us after as the result of a car accident, additional information is required.  Please complete this form as well as the New Patient Form

Chiropractic is composed of a science, art and philosophy. It was truly the philosophy, that underlying belief in a vitalistic model, that the body is living, full of intelligence, and ultimately self-correcting and healing, that I fell in love with.

After 27 years of practice, I am still amazed at the perceived miracles I witness daily in regards to healing by simply providing the body with the specific nutrients it needs to heal and repair itself. Of course it's not a miracle, it's normal biochemistry.

The way to healing our world begins with healing ourselves; pure body,
clear mind, open heart.

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